8 Fla. L. Weekly Supp. 245b
Insurance — Personal injury protection — Complaint for PIP benefits and declaratory relief based on medical treatment provided by medical provider to insured for injuries sustained in automobile related accident — Section 627.736(5)(b) which requires medical providers to submit to insurer the bill for medical treatment rendered to insured within 30 days of providing treatment, is constitutional as written and as applied — Access to courts — Regarding argument that statute violates medical providers’ access to courts, provider has complete access to the court to recover from insured and/or insurer, assuming provider complies with notice requirements of statute — Pursuant to (5)(b), no one is denied access to court; instead, access is merely regulated by billing requirements of that section — Due process — As to due process argument that statute makes unreasonable and arbitrary distinction for emergency service providers by not requiring these providers to bill insurer within 30 days of providing services, distinction between emergency service providers and other medical service providers bears reasonable relationship to legislative concerns of stopping practice of “bulk billing” by providers and making insurer aware of commencement of treatment — Impairment on contracts — Freedom to contract is not totally denied since only medical provider’s failure to comply with notice requirements of statute will excuse payment of services rendered by medical provider
JOHN ORTOLANI, M.D., a/a/o ANNIE FELTON, Plaintiff, vs. INFINITY INSURANCE COMPANY, Defendant. County Court, 7th Judicial Circuit in and for Volusia County. Case No. 00-33247-COCI. January 25, 2001. Peter F. Marshall, Judge. Counsel: Frederick S. Jaeger, Jr., Daytona Beach. Brian T. Foreman, Orlando. Joseph H. Lee, Tampa.
ORDER
This cause having come on to be heard pursuant to the Plaintiff’s Motion for Summary Judgment and the Court having taken notice of the court file, having listened to the arguments of counsel and otherwise being fully advised of the premises; the Court makes the following finding upon which it enters this Order denying the motion.
The Plaintiff has filed a two count Complaint seeking: 1) PIP Benefits and 2) Declaratory Relief. This Complaint is based upon medical treatment provided by John Ortolani, M.D. to Annie Felton for injuries sustained in an automobile related accident and the subsequent charge for this treatment that was submitted to Annie Felton’s PIP insurer, the Defendant. The Defendant has refused to pay for the medical treatment rendered by the Plaintiff because the Plaintiff failed to submit the bill within 30 days of providing the treatment as required by Florida Statute 627.736(5)(b). There are no disputed facts and the parties have submitted a Joint Stipulation that the only issue before the Court regarding the Motion for Summary Judgment is the constitutionality of F.S. 627.736(5)(b) as written and/or as applied in this case.
The Plaintiff has raised three arguments against the constitutionality of this statute: (1) it violates the Plaintiff’s right to access to the courts; (2) it violates the Plaintiff’s due process rights; and (3) it unreasonably and arbitrarily infringes on the Plaintiff’s freedom to contract.
Regarding the right to access to the courts, the Plaintiff points out that (5)(b) cuts off a medical provider’s right to recover from the insurer or the insured if the bill for medical treatment is not submitted within 30 days of providing treatment. (Actually the provider has up to 60 days to submit its bill if a notice of initiation of treatment is submitted within 21 days of the first examination or treatment.) The Defendant makes the point that the reverse is true, i.e. the insurer has only 30 days in which to pay or deny the claim otherwise the benefits shall be deemed “overdue” and thereby subjecting the insurer to various penalties. The Plaintiff’s reliance on Nationwide Mutual Fire Insurance Company v. Pinnacle Medical, Inc., 753 So.2d 55, (Fla. 2000), is misplaced as the issue before that court dealt with the arbitration requirement of F.S. 627.736(5)(c). The Pinnacle holding is distinguishable as it focuses on the denial of court access to a medical provider when an insured is permitted to bring suit against the insurer. Pursuant to (5)(b), no one is denied access to the court; instead, access is merely regulated by the billing requirements of that section. Assuming the provider complies with (5)(b), the provider has complete access to the court as to the insured and/or the insurer. This result is consistent with the intent of the Legislature in enacting the Florida Automobile Reparations Act to encourage settlements and to minimize litigation, Williams v. Gateway Insurance Company, 331 So.2d 301, (Fla. 1976).
As to Plaintiff’s violation of due process argument, it is alleged that (5)(b) makes an unreasonable and arbitrary distinction for “emergency services” rendered at a hospital emergency department or by an ambulance provider. These providers are not required to bill the insurer within 30 days of providing services as are other medical service providers. The test to be applied to the Plaintiff’s violation of due process argument is whether or not this distinction bears a reasonable relationship to a legislative objective. A review of the Senate Staff analysis regarding the 1998 Amendment of F.S. 627.736(5)(b) discloses several legislative concerns. First there is a concern in stopping the practice of “bulk billing” by providers and secondly, it makes the insurer aware of the commencement of treatment and thereby the insurer is better able to assure that the treatment is reasonable, related to the motor vehicle accident, or necessary. By their very nature, “emergency services” are more likely to be a one-time service provided under emergency (i.e. necessary) conditions therefore the concerns of “bulk billing” and commencement of treatment are not present.
Plaintiff’s final constitutional challenge goes to the alleged infringement on the freedom to contract. Plaintiff offers the argument that pursuant to (5)(b), no agreement can be entered into between the insured (patient) and the provider (doctor) that will make the insured responsible for the payment of any medical services rendered by the provider. As discussed in the Plaintiff’s first constitutional challenge, only the provider’s failure to comply with the notice requirements of (5)(b) will excuse the payment for services by the injured party. This is a far cry from the total denial of the freedom to contract alleged by the Plaintiff. This is also in keeping with the notion that statutory provisions under Florida’s no fault laws will be construed liberally in favor of the insured, United Automobile Insurance Company v. Viles, 726 So.2d 320 (Fla. App. 3 Dist. 1999).
Beginning with the premise that legislative enactments are presumed constitutional, and that the Court has the obligation to resolve all doubts as to the validity of a statute in favor of its constitutionality, State v. Lick, 390 So.2d 52, (Fla. 1980); and then considering that the party challenging a statute’s constitutionality must carry the burden of establishing that the statute bears no reasonable relationship to a permissible legislative objective, State v. Powell, 497 So.2d 1188, (Fla. 1986); this Court finds that the Plaintiff has not met its burden challenging the constitutionality of F.S. 627.736(5)(b). It is therefore,
ORDERED and ADJUDGED that F.S. 627.736(5)(b) is constitutional as written and as applied in this case. That based upon this finding the Plaintiff’s Motion for Summary Judgment is hereby DENIED.
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